NPIMap

Individual provider Active NPI

Abdallah Altarshan, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Evergreen Park, IL
National Provider Identifier
1174582811
Registry record updated Mar 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
036093254 Issued in IL
Practice address
2955 W 95TH St
Evergreen Park, IL 60805-2409
Phone
(708) 422-0022
NPI assigned
Mar 21, 2006
Last updated
Mar 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036093254 IL
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 036093254 IL Primary

Addresses

Primary practice location

2955 W 95TH St
Evergreen Park, IL 60805-2409

Mailing address

2955 W 95TH St
Evergreen Park, IL 60805-2409
Phone (708) 422-0022

Other practice location 1

15300 West Ave Ste 122
Orland Park, IL 60462-4508
Phone (708) 403-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060111001056 IL Practitioner - EndocrinologyPractitioner - Internal Medicine 2668449281 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians
Diabetes and Endocrine Care LTDGroup PAC ID 3779504584, 2 clinicians

Practice addresses (Care Compare)

15300 W Ave
Suite 122
Orland Park, IL 60462-4508
Phone (708) 923-4400

2955 W 95TH St
Evergreen Park, IL 60805-2409
Phone (708) 422-0022

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036093254ILMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group Internal Medicine CurrentSince Nov 1, 2021 Accepting new patients
Diabetes & Endocrine Care LTD Endocrinology, Diabetes & Metabolism CurrentSince Dec 13, 2005 Accepting new patients
Hama Medical Group LTD Internal Medicine CurrentSince Apr 1, 2016 Accepting new patients
Central Dupage Physician Group CurrentSince Nov 1, 2021 Accepting new patients
Loyola University Physician Foundation Past Accepting new patients
Northern Indiana Emergency Physicians, LLP Past Accepting new patients
St. Vincent Health Wellness and Preventive Care Institute, Inc. Past Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

2955 W 95th St
Evergreen Pk, IL 60805
Phone (708) 422-0022

15300 West Ave
Ste 122
Orland Park, IL 60462
Phone (708) 226-2400

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AFAHBA/Endpoint/AFAHBA

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647561600000",
    "number": "1174582811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2955 W 95TH ST",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052409",
            "telephone_number": "708-422-0022",
            "fax_number": "708-422-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 W 95TH ST",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052409",
            "telephone_number": "708-422-0022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15300 West Ave Ste 122",
            "address_purpose": "LOCATION",
            "city": "Orland Park",
            "state": "IL",
            "postal_code": "604624508",
            "country_code": "US",
            "telephone_number": "708-403-8400",
            "fax_number": "708-403-8492",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALTARSHAN",
        "first_name": "ABDALLAH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036093254",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IL",
            "license": "036093254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

Verify at the official NPI Registry.